True Anomaly

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True Anomaly last won the day on October 8 2016

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About True Anomaly

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    Emergency Medicine PA

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    Physician Assistant

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  1. As a policy, we've stopped doing rapid flu tests for patients being discharged. If they are admitted, we swab for the flu- if it ends up being negative (which as as lot of you pointed out, is occurring frequently), then it automatically reflexes to the NAT test for confirmation. For discharge, I'm under no pressure to either prescribe or not prescribe tamiflu. I **always** have that talk with patients regarding cost, potential side effects, and how little it affects duration of illness- but if they're high risk, I still give it to them because as others have pointed out, potential secondary issues such as sepsis or bacterial pneumonia could be devastating
  2. I never use medrol dose paks. It's either 60 mg prednisone for 5 days, or 10 mg decadron PO once (or equivalent doses for pediatrics)
  3. I wasn't able to negotiate any increased salary Since I started my new job a few years ago, I was able to show I was competent enough in emergency medicine to quickly gain the trust of other APPs and attendings. I only got there because of the effort I put into my residency and then working in the same place as a staff PA for a few years after the residency.
  4. I won't repeat a lot of what has been said here, but I was in a similar place as you when I was a student- I had a mentor I trusted who did not think I should do a residency, but it was mostly her beliefs about PAs not being limited by specialty training rather than what was best for ME. She had some similar things to say as your mentor did. If you read my thread regarding residency, you'll also know that I felt it was more than worth it for me, for too many reasons to count- many of which were described by Serenity very well above. I've said this before, but I think it bears repeating- what exactly does it mean to have "clinical experience" and take care of patients in a particular specialty? It means you know how to approach patients and THINK like someone who also has experience in that particular specialty. The ability to think in an ER mindset is different than other specialties. You learn what the standard of care is, how to understand the latest literature, who the "experts" are in the ER world and how they think- and maybe you'll be lucky enough to work with someone like that (I got to work with Richard Levitan the first part of my intern year, since he was one of my attendings). It's great to tout how many advanced procedures you get to do, but the greatest value of a residency- to me- is teaching someone how to think in that specialty.
  5. Nah, I'm nowhere near there- it was more a general statement in contrast with others who have noted that ER PA's are a "hot commodity". I just haven't felt the same love :D Carry on
  6. Man, I'm an experienced ER PA and I have really never received any offers to go anywhere else. Not that I would go anywhere else, but it feels nice to be wanted every once in a while :D
  7. This is not unlike mandating that there is no food or drink in patient care areas...while patients and family are able to bring in all manners of eats and drinks into a patient care area. No logic behind it, yet most hospitals still adhere to this outmoded thinking
  8. E took the words right out of my mouth
  9. Could've been worse- could've had her standing next to a doctor handing him/her a stethoscope. It was a little cringey, but baby steps- it was kinda cool to see a PA manning a mobile health clinic by themselves
  10. I had no idea the Arrowhead program has as large as classes as it does. Dennis Tankersley is a great program director and was a key part of developing SEMPA's ER Post-graduate standards
  11. Shepard Stone definitely qualifies https://pahx.org/assistants/stone-shepard-b/
  12. If you fill out a rx, and doctor signs it and is okay with what you write on the prescription, there's really no difference in you actually writing the prescription and literally anyone else writing it- the doc is the one who signs it, so long as they know about and approve the prescription and there's charting to reflect this. In Texas, there is no legal requirement for % of chart signage, or even that charts have to be co-signed. The facility you work at may require a certain percentage, or the prescription delegation agreement between you and the doc may require a % of chart review, but nothing in state law requires it. Starting Sept 1st, only requirement for prescription delegation is that you and the doc meet once a month- which could be via in person, teleconferencing or however y'all decide to do it- so long as it's outlined in the delegation agreement.
  13. Locking this thread due to duplication- use the more active thread for further posts
  14. That's a question each person is going to answer differently. For myself, I know working more than 3 ER days in a row is pretty draining, and although I don't request that in my schedule, if I was to schedule myself I would make sure I don't work more than 3 days in a row
  15. I sincerely doubt anyone could make a case of actual malpractice from providing advice on weight loss to an obese patient